Wislon, Sylvia BMK NEW YORK STATE DEPARTMENT OF H EALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Sylvia BMK Wilson Female
Date of Death Age If Veteran of U.S.Armed Forces,
02/07/2021 73 Years War or Dates
F Place of Death Hospital,Institution or
WCity,Town or Village Saratoga Springs Street Address Saratoga Hospital
p Manner of Death 0 Natural Cause ❑Accident El Homicide ❑Suicide ❑Undetermined Pending
Circumstances Investigation
W Medical Certifier Name Title
CI Jennifer White DO
Address
211 Church St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City,Town or Village Saratoga Springs 4501 132
❑Burial Date Cemetery,Crematory or Facility Name
02/09/2021 Pine View Crematory
❑Entombment Address
X❑Cremation Queensbury Town,New York
Donation
❑Removal Date Place Removed
and/or and/or Held
N Hold Address
0
d 1-1 Dale Point of
U) ❑Transportation
p by Common Shipment
Carrier Destination
Disinterment
Date Cemetery Address
Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care Inc 00364
Address
402 Maple Ave,Saratoga Springs,New York 12866
Name of Funeral Firm Making Disposition or to Whom
1— Remains are Shipped,If Other than Above
Address
CC
W
O. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 02/09/2021 Registrar of Vital Statistics join PaulTranck(ElectronicaK Stgned)
(signature)
District Number 4501 Place Saratoga Springs, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W~ ( ��
Date of Disposition 2�ii)Z Place of Disposition
2 (address)
W
NCC (section) (!ot number) (grave number)
aName of Sexton or Person in Charge of Premises ` tsits-, 1�l'�
Z � (Plea print/
W � /,Signature �T Title 6W"Ml4TW
DOH-1555(o7/18)p t of 2
Public Health Law Sec. 4145(2b) 0 '4 5 31
Receipt
Human remains of delivered on , 20 '
L y...
Pine View Cemetery Representing the funeral home named 9i burialpermit
Official Funeral Directors Reg.or License#